Development of a Novel Prognostic Nomogram for the Early Recurrence of Liver Cancer After Curative Hepatectomy

Overview

Journal Ann Transl Med

Publisher AME Publishing Company

Date 2021 Nov 18

PMID 34790747

Citations 6

Authors

Wuzheng Xia

Tianyi Peng

Renguo Guan

Yu Zhou

Cong Zeng

Ye Lin

Zhongshi Wu

Hongmei Tan

Affiliations

Soon will be listed here.

Abstract

Background: Hepatocellular carcinoma (HCC) is one of the most common malignant cancers worldwide. Curative resection is an effective treatment but HCC recurrence rates remain high. This study aimed to establish a novel prognostic nomogram to assess the risk of recurrence in patients following curative resection.

Methods: A total of 410 patients undergoing HCC curative resection were recruited from the Guangdong Provincial People's Hospital (GDPH). The cohort was divided into a training group (n=291) and a validation group (n=97). The risk factors for HCC early recurrence within 1 year of curative hepatectomy were identified. Finally, a multivariate prognostic nomogram was developed and validated.

Results: Age, tumor number, tumor capsule, portal vein tumor thrombi, pathological grade, vascular tumor emboli, activated partial thromboplastin time (APTT), and tumor size were identified as independent prognostic risk factors for HCC early recurrence within 1 year of curative hepatectomy. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.806 [95% confidence interval (CI): 0.755 to 0.857; P<0.001], and no AUC/ROC statistical difference was detected between the training and validation sets.

Conclusions: The nomogram effectively predicted postoperative HCC recurrence within 1 year after curative hepatectomy, which may be a useful tool for the postoperative treatment or follow up for HCC patients.

Citing Articles

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References

Sumie S, Kuromatsu R, Okuda K, Ando E, Takata A, Fukushima N . Microvascular invasion in patients with hepatocellular carcinoma and its predictable clinicopathological factors. Ann Surg Oncol. 2008; 15(5):1375-82. DOI: 10.1245/s10434-008-9846-9. View

Sprinzl M, Galle P . Current progress in immunotherapy of hepatocellular carcinoma. J Hepatol. 2016; 66(3):482-484. DOI: 10.1016/j.jhep.2016.12.009. View

Zhu W, Huang C, Li C, Peng W, Wen T, Yan L . Risk factors for early recurrence of HBV-related hepatocellular carcinoma meeting milan criteria after curative resection. Asian Pac J Cancer Prev. 2014; 14(12):7101-6. DOI: 10.7314/apjcp.2013.14.12.7101. View

Du Z, Wei Y, Chen K, Li B . Risk factors associated with early and late recurrence after curative resection of hepatocellular carcinoma: a single institution's experience with 398 consecutive patients. Hepatobiliary Pancreat Dis Int. 2014; 13(2):153-61. DOI: 10.1016/s1499-3872(14)60025-4. View

Roayaie S, Jibara G, Taouli B, Schwartz M . Resection of hepatocellular carcinoma with macroscopic vascular invasion. Ann Surg Oncol. 2013; 20(12):3754-60. DOI: 10.1245/s10434-013-3074-7. View

Xu W, Li R, Liu F . Novel Prognostic Nomograms for Predicting Early and Late Recurrence of Hepatocellular Carcinoma After Curative Hepatectomy. Cancer Manag Res. 2020; 12:1693-1712. PMC: 7082541. DOI: 10.2147/CMAR.S241959. View

Poon R . Differentiating early and late recurrences after resection of HCC in cirrhotic patients: implications on surveillance, prevention, and treatment strategies. Ann Surg Oncol. 2009; 16(4):792-4. DOI: 10.1245/s10434-009-0330-y. View

Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6):394-424. DOI: 10.3322/caac.21492. View

Chan A, Zhong J, Berhane S, Toyoda H, Cucchetti A, Shi K . Development of pre and post-operative models to predict early recurrence of hepatocellular carcinoma after surgical resection. J Hepatol. 2018; 69(6):1284-1293. DOI: 10.1016/j.jhep.2018.08.027. View

10.

Sun W, Cabrera R . Systemic Treatment of Patients with Advanced, Unresectable Hepatocellular Carcinoma: Emergence of Therapies. J Gastrointest Cancer. 2018; 49(2):107-115. PMC: 5948236. DOI: 10.1007/s12029-018-0065-8. View

11.

Fuks D, Dokmak S, Paradis V, Diouf M, Durand F, Belghiti J . Benefit of initial resection of hepatocellular carcinoma followed by transplantation in case of recurrence: an intention-to-treat analysis. Hepatology. 2011; 55(1):132-40. DOI: 10.1002/hep.24680. View

12.

Lim K, Chow P, Allen J, Chia G, Lim M, Cheow P . Microvascular invasion is a better predictor of tumor recurrence and overall survival following surgical resection for hepatocellular carcinoma compared to the Milan criteria. Ann Surg. 2011; 254(1):108-13. DOI: 10.1097/SLA.0b013e31821ad884. View

13.

Collins G, Reitsma J, Altman D, Moons K . Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. BMJ. 2015; 350:g7594. DOI: 10.1136/bmj.g7594. View

14.

Kim H, Park M, Park Y, Kim H, Kim K, Choi J . Preoperative radiologic and postoperative pathologic risk factors for early intra-hepatic recurrence in hepatocellular carcinoma patients who underwent curative resection. Yonsei Med J. 2010; 50(6):789-95. PMC: 2796405. DOI: 10.3349/ymj.2009.50.6.789. View

15.

Singh A, Kumar R, Pandey A . Hepatocellular Carcinoma: Causes, Mechanism of Progression and Biomarkers. Curr Chem Genom Transl Med. 2018; 12:9-26. PMC: 6047212. DOI: 10.2174/2213988501812010009. View

16.

Kow A, Kwon C, Song S, Shin M, Kim J, Joh J . Risk factors of peritoneal recurrence and outcome of resected peritoneal recurrence after liver resection in hepatocellular carcinoma: review of 1222 cases of hepatectomy in a tertiary institution. Ann Surg Oncol. 2012; 19(7):2246-55. PMC: 3381119. DOI: 10.1245/s10434-012-2260-3. View

17.

Forner A, Reig M, Bruix J . Hepatocellular carcinoma. Lancet. 2018; 391(10127):1301-1314. DOI: 10.1016/S0140-6736(18)30010-2. View

18.

EDMONDSON H, STEINER P . Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies. Cancer. 1954; 7(3):462-503. DOI: 10.1002/1097-0142(195405)7:3<462::aid-cncr2820070308>3.0.co;2-e. View

19.

Chew V, Lai L, Pan L, Lim C, Li J, Ong R . Delineation of an immunosuppressive gradient in hepatocellular carcinoma using high-dimensional proteomic and transcriptomic analyses. Proc Natl Acad Sci U S A. 2017; 114(29):E5900-E5909. PMC: 5530700. DOI: 10.1073/pnas.1706559114. View

20.

Toyoda H, Kumada T, Kiriyama S, Sone Y, Tanikawa M, Hisanaga Y . Comparison of the usefulness of three staging systems for hepatocellular carcinoma (CLIP, BCLC, and JIS) in Japan. Am J Gastroenterol. 2005; 100(8):1764-71. DOI: 10.1111/j.1572-0241.2005.41943.x. View